eComment: What is the best way to diagnose and stage malignant pleural mesothelioma?

Our plain-English summary of eComment: What is the best way to diagnose and stage malignant pleural mesothelioma?, by S. Cafarotti, V. Porziella, S. Margaritora, et al (Interactive Cardiovascular and Thoracic Surgery, 2011).

The study

• Authors: S. Cafarotti, V. Porziella, S. Margaritora, P. Granone
• Journal: Interactive Cardiovascular and Thoracic Surgery
• Published: 2011;12(5):811
• Type of article: Comment
• Read it: PubMed · Publisher

In plain English

This was a short published comment, not a research study. The authors, from the Department of Thoracic Surgery at the Catholic University in Rome, Italy, responded to an article by Sharif and colleagues on PET-CT scanning (a combined imaging scan) in the diagnosis and outlook of malignant pleural mesothelioma. No patients were studied, no new data were reported, and asbestos exposure was not discussed. The authors stated that there is no agreement on which single test should confirm the diagnosis before surgery. They wrote that PET-CT is increasingly used to tell mesothelioma apart from benign pleural disease, to stage it before surgery, to watch for recurrence and to judge response to treatment. They wrote that PET-CT seems better than other imaging at finding more extensive disease and hidden distant spread. Citing other papers, they argued that pleural biopsy still gives the most accurate diagnosis and that tissue is needed to identify the tumor subtype (epithelial, sarcomatoid or biphasic), which affects outlook. The authors concluded that combining PET-CT with biopsy offers the best way to diagnose and stage the disease.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Commentary (eComment) responding to another published article; no original data
• Who was studied: No patients or subjects were studied; the comment discusses diagnosis and staging of malignant pleural mesothelioma in general
• Main results:
  • The authors stated that there is currently no consensus on which single test should confirm the diagnosis before surgery
  • The authors wrote that PET-CT is increasingly used in assessing patients with known or suspected malignant pleural mesothelioma: to tell it apart from benign pleural disease, for staging before surgery, for watching for recurrence after treatment, and for judging response to therapy
  • The authors wrote that PET-CT seems better than other imaging methods at detecting more extensive disease and finding unsuspected hidden distant metastases
  • Citing another paper by the Sharif group, the authors stated that surgical or radiological pleural biopsy still gives the most accurate definitive diagnosis, though it is more invasive than PET-CT
  • Citing another study, the authors argued that tissue confirmation is required because histological subtype is an established prognostic factor, and that classifying tumors into one of three subtypes (epithelial, sarcomatoid, biphasic) is necessary to assess prognosis
• The authors' conclusion: The authors concluded that obtaining cellular or large tissue samples at the first examination is recommended, and that combining PET-CT with biopsy offers the best way to diagnose and stage malignant pleural mesothelioma

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

Related studies

• What is the best way to diagnose and stage malignant pleural mesothelioma? — I. Zahid, S. Sharif, et al. (2011)
• Does positron emission tomography offer prognostic information in malignant pleural mesothelioma? — S. Sharif, I. Zahid, et al. (2011)
• Integrated positron emission tomography-computed tomography does not accurately stage intrathoracic disease of patients undergoing trimodality therapy for malignant pleural mesothelioma — J. Pilling, J.A. Dartnell, et al. (2010)
• FDG PET/CT is useful for detecting infiltration to the port site in patients with malignant pleural mesothelioma — K. Kawaguchi, T. Taniguchi, et al. (2014)
• Role of integrated 18-fluorodeoxyglucose position emission tomography-computed tomography in patients surveillance after multimodality therapy of malignant pleural mesothelioma — C. Tan, S. Barrington, et al. (2010)
• Prognostic value of 18F-FDG standard uptake value by integrated PET/CT in the staging of malignant pleural mesothelioma — G. Genestreti, A. Moretti, et al. (2012)

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